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7/23/2019 Medical Career Selection
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Selecting the MedicalSpecialty That Is Right for
You
Jim Holliman, M.D., F..!.".#.
#rogram Manager, fghanistan Healthcare Sector Reconstruction #ro$ect
!enter for Disaster and Humanitarian ssistanceMedicine
%niformed Ser&ices %ni&ersity of the HealthSciences
!linical #rofessor of "mergency Medicine
'eorge (ashington %ni&ersity
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)uestions to s* Yourself s Youre Deciding on a Medical !areerSpecialty
ƒ +. Do I li*e diagnostics or therapeutics or oth-
ƒ . Do I li*e predictaility or unpredictaility,and can I deal /ith more than one case at atime -
ƒ 0. Do I ha&e any pre$udicial disli*es of certain
*inds or ages of people - ƒ 1. Do I need de2ned limits to /hat I need to
*no/ -
ƒ 3. !an I /or* in a team en&ironment -
ƒ 4. Do I ha&e &eral communicationlimitations -
) i * Y lf Y
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)uestions to s* Yourself s Youre Deciding on a Medical !areerSpecialty
+. Do I li*e diagnostics or therapeutics8procedures9 or oth -
ƒ If you don:t ha&e any manual de;terity, thendon:t choose a procedural specialty
ƒ <#ure procedural= specialties > #lasticSurgery, ?rthopedic Surgery
ƒ <#ure diagnostic= specialties > @eurology,#re&enti&e Medicine, RehailitationMedicine
ƒ <Mi;ed procedural and diagnostic=
specialties > "mergency Medicine, 'eneralSurgery
) ti t * Y lf Y
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)uestions to s* Yourself s Youre Deciding on a Medical !areerSpecialty
. Do I li*e predictaility or unpredictaility,and can I deal /ith more than one case at a
time -6 If you don:t li*e or tolerate unpredictaility,then you /ant to choose a clinic or oAceased practice, such as Internal Medicine,
Family Medicine, or #ediatrics 8perhaps/ithout hospital admission pri&ileges9
6 Specialties /ith unpredictaility of patientpresentations include "mergency Medicine,Trauma Surgery, and 'eneral Surgery
6 Some specialties such as !ritical 8Intensi&e9
) ti t * Y lf Y
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)uestions to s* Yourself s Youre Deciding on a Medical !areerSpecialty
ƒ 0. Do I ha&e any pre$udicial disli*es of certain*inds or ages of people 8or do I /ant to treat
all types and ages of people9 - ƒ For e;ample, f you don:t li*e *ids, then
don:t go into #ediatrics or Family Medicine
ƒ In "mergency Medicine you ha&e to li*e to
deal /ith all types and all ages of people ƒ If you don:t ha&e patience /ith the elderly,
then don:t go into Internal Medicine or"mergency Medicine
) ti t * Y lf Y
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)uestions to s* Yourself s Youre Deciding on a Medical !areerSpecialty
1. Do I need de2ned limits as to /hat I need to*no/ B study -
- Some people are &ery uncomfortale /ith aspecialty such as "mergency Medicine in/hich the ody of clinically importantinformation to *no/ and study is essentially
unounded- So if you /ant de2ned limits as to the*no/ledge ase reCuired for clinical practice,then choose <more focused= specialties suchas ?phthalmology, nesthesia,?tolaryngology, etc.
) ti t * Y lf Y
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)uestions to s* Yourself s Youre Deciding on a Medical !areerSpecialty
3. !an I /or* in a team en&ironment -
6 If you:d rather /or* solo, then pic* an oAce
or clinic ased specialty6 "mergency Medicine and Rehailitation
Medicine particularly reCuire close team/or*/ith other department personnel
) ti t * Y lf Y
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)uestions to s* Yourself s Youre Deciding on a Medical !areerSpecialty
4. Do I ha&e &eral communication limitations -
6 If you don:t li*e to or are not good at Cuic*ly
estalishing rapport and &eralcommunications /ith patients, then youshould choose nesthesia or Radiology /herethese aspects are not as important as in
specialties such as Family Medicine, InternalMedicine, #ediatrics, and "mergency Medicine
)uestions to s* Yourself s You
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)uestions to s* Yourself s Youre Deciding on a Medical !areerSpecialty
5. Is my 2nal career goal a su6specialty ormultiple specialties -
6 If so, you need to consider the ase specialtyyou /ill need to complete 2rst efore goingon to the suspecialty.
For e;ample, you can enter !ritical !are
Fello/ships &ia nesthesia, InternalMedicine, Surgery, or "mergency Medicine.
6 If you /ant to e certi2ed in more than onespecialty then you can enter one of se&eral
comined residencies > "M IM, "M #eds,"M FM, etc.
)uestions to s* Yourself s You
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)uestions to s* Yourself s Youre Deciding on a Medical !areerSpecialty
7. !an I tolerate the humdrum and disagreealeaspects of the specialty I ha&e chosen -
- This is often the most important Cuestion toconsider
- For e;ample, if you /ant to e a neurologist,then you must e ale to tolerate patients
/ith chronic undiEerentiated headaches- Rememer that in many surgical specialties
you /ill e doing the same limited numer ofprocedures o&er and o&er
- lso rememer that in most clinical practicesyou /on:t see the &ariety or se&erity of cases
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)uestions to s* Yourself inDeciding on an cademic !areer
ersus #ri&ate #ractice -
ƒ !an I tolerate turning o&er care of my
patients to trainees - ƒ Do I prefer to do e&erything myself to ma*e
sure itGs done right -
ƒ Do I /ant to listen to my spouse yell at me
for /or*ing t/ice as hard for half as muchmoney in academic practice as my medicalschool classmates are ma*ing in pri&atepractice -
ƒ Do the re/ards of teaching and scholarshipout/eigh the e;tra political hassles of
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(hy Is "mergency
Medicine 'reat !areer - ƒ @ice mi; of diagnostics B therapeutics
8procedures9
ƒ (ide &ariety of patients B medicalprolems
ƒ !hallenging
ƒ ene2ts to patients B %. S. health care
are o&ious
ƒ !ore component of %.S. health caresystem
ƒ Young, &irant specialty manypractitioners ha&e e;tensi&e interests
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(hat out #rimary !are
!areers - ƒ !lassic primary care specialties include >
–#ediatrics
–Family #ractice–Internal Medicine
ƒ The degree of go&ernmental support forthese to the e;clusion of other specialties
is /aning ƒ %sually do not include any trauma training
ƒ True longitudinal care in these may note practiced
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Disad&antages of"mergency Medicine s a
!areer ƒ You /onGt ma*e as much money as in
cardiac surgery
ƒ Kimited longitudinal care ƒ @o aility to pre6select patients
ƒ %sually spatially limited /or*en&ironment
ƒ @eed to stay current in all 2elds ofmedicine
ƒ ReCuires a lot of political s*ill 8the art ofma*ing other doctors actually do /hat
you oth *no/ is the right thing to do9
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%niCue d&antages of"mergency Medicine s a
!areer ƒ %nlimited international de&elopment
opportunity
ƒ Relati&ely small numer of academicpractitioners 8easy to rise to the topfast9
ƒ !ontrol o&er, B predictaility of, /or*
schedules ƒ #otential for administrati&e
in&ol&ement in prehospital care
ƒ Interact /ith e&ery other medical
specialty'eo ra hic Le;iilit
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(hat Does the FutureHold for "mergency
Medicine - ƒ They may 2nd a cure for cancer they
may 2nd a cure for heart disease ut they/ill ne&er 2nd a cure for stupidity, so there/ill al/ays e accidents B a need foremergency physicians
ƒ Is currently an undersupplied specialty in
the %.S. ƒ Is $ust eginning to de&elop in other
countries the %.S. is the unCuestioned/orld leader in this specialty
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Important #rinciples to Rememerin Deciding %pon a Medical !areer
Specialty ƒ Does my chosen career mesh /ith my
personality -
ƒ Does my chosen career match /ith mysigni2cant other:s long term /ishes -
ƒ !an I stand the dull, humdrum, anddisagreeale aspects of my chosen 2eld, and dothe interesting or infreCuent e;citing aspectsof my chosen 2eld suAciently ma*e up forthese other aspects -
ƒ 8Seriously9 > It is est to *eep an open mind asyou are doing your third year rotations you
may 2nd you really li*e a specialty you had nothad e;posure to efore
a ou o an
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a ou o anDecide on a Specialty Kate in myThird Year -
ƒ If you can narro/ it to t/o specialties > for your2rst fourth year rotation ta*e an actinginternship in one follo/ed y a second actinginternship in the other, follo/ed y one montheach of a rotation related to each specialty prepare t/o diEerent personal statements o&erthe summer ma*e a 2nal decision and apply to
only one specialty at the end of Septemer. ƒ If you still ha&e no decision y your fourth
year > apply to transitional internships,schedule rotations related to your specialty
interests early in the transitional internship,then reapply to a single specialty the ne;t year
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My Recommendations for StudentsInterested in pplying for ". M.
Residencies ƒ Ta*e ".M. electi&e early in 1th year, then ta*e a
rotation that /ill uE your clinical s*ills such asSurgical I!%
ƒ Then ta*e second ".M. electi&e at another center/ith an ".M. residency
ƒ 'et 0 letters of recommendation from ".M. facultyat these places
ƒ ?&er the summer draft and edit your ! andpersonal statement
ƒ !omplete all @RM# application materials y?ctoer
ƒ Ta*e the time and e;pense to tra&el to any
residency that oEers you an inter&ie/ ƒ Do an o&erseas electi&e in March or pril /hile
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Recommended 1th Year "lecti&es forStudents Interested in ".M. 8in
addition to the ".M. electi&es9
ƒ Medical, Surgical, and or #ediatricI.!.%.
ƒ ?utpatient #ediatrics ƒ ?utpatient ?rthopedics
ƒ nesthesia
ƒ Dermatology
ƒ %rology
ƒ Medicine or Surgery Suinternship
ƒ #lastic Surgery
ƒ Trauma Surgery
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Fourth Year "lecti&es @?TRecommended for Students
Interested in ".M. ƒ Radiology
ƒ Radiology suspecialties
ƒ Radiation oncology ƒ Medicine suspecialties
ƒ #sychiatry
ƒ Rehailitation
ƒ ?ncology
ƒ Family practice
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dditional Items to !onsider toolster Your Residency
pplication
ƒ 'et faculty to re&ie/ your !.. B personalstatement
ƒ Join se&eral student interest groups ƒ Do some pulic ser&ice pro$ects
ƒ Do a decent research pro$ect8s9
ƒ Join MS, M, !"#, S"M, etc.
ƒ ecome *no/ledgeale aout currentaEairs B political aspects of medicine
ƒ De&elop some interests esides readingB sleeping
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(hat Should You Do if Youpply to ".M. #rograms B DonGt
'et In - ƒ DonGt reapply if youGre actually a dor*
ƒ If you are not a dor* >
6 Ser&e out your 'M? time and thenreapply
– pply to transitional internships 8these arereCuired for the #'Y ,0,1 programs
any/ay9– Ta*e a research position B reapply ne;t
year
– nalyNe /hat /as /ea* in your 2le and try
and 2; or augment it– (or* as an ".D. &olunteer or in prehospital
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RecogniNed Suspecialties of
"mergency Medicine ƒ To;icology
ƒ #ediatric "mergency Medicine
ƒ Sports Medicine ƒ #alliati&e Medicine
ƒ ".M.S. 8prehospital care9
ƒ eromedical !are
ƒ !ritical !are
ƒ Disaster Medicine
ƒ International ".M.
@ote the 2rst 1ha&e oAcialsuspecialty
certi2catione;ams
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Ho/ to Find ?ut MoreInformation on "mergency
Medicine !areers ƒ Consult the unbiased Dr. Holliman and / or Dr. Burns
in the office anytime and shadow them when they’re
on clinical duty
ƒ Come to "Career Night" at Dr. Holliman's house
(arty for students held twice a year!
ƒ al# to the $.%. residents at & or &eorgetown
ƒ al# to the $.%. attendings at any of the localhositals
ƒ )oin *C$+, -*$%, the student $.%. nterest &rou
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